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Dr William Moreland has spent much of his life attending to the physical and mental health of the inhabitants of Knife Island, a tiny Micronesian community. Feeling that his records should be analysed to ensure that the wealth of information contained within them should not be lost, he asks Alex Delaware for assistance.

The timing is perfect for Alex and his partner Robin. Desperate to escape the violence of Los Angeles and recuperate from a terrible ordeal, they seize the opportunity for a sabbatical.

But Knife Island isn't the tropical paradise it first appears. The murder of a young woman has created an atmosphere of fear and division and Moreland himself is not quite what he seems.

Surrounded by tarantulas and giant hissing cockroaches, Alex and Robin find themselves drawn into a grotesque web of intrigue that even Alex, with his deep knowledge of the human psyche, finds it hard to unravel.